Infertility in Sub-Saharan Africa: A Woman’s Issue for How Long? A Qualitative Review of Literature

Abstract

Infertility or childlessness is a major reproductive health issue for females as well as males respectively. Many couples suffer from infertility worldwide and in Sub-Saharan Africa, which has a cultural preference for high fertility; women shoulder the highest infertility consequences. The objective of this review was therefore to explore socially acceptable and culturally effective reproductive health strategies for the social management of infertility in sub-Sahara Africa. Different databases were searched to source articles on infertility in Sub-Saharan Africa. The databases included Medline, Pubmed and Fudan University library. Google scholar was also utilized to get additional relevant articles. Titles and abstracts of the articles searched were critically evaluated for relevance based on the inclusion criteria. Final extraction of the articles was done by getting only those studies that met the inclusion criteria. Twenty articles were identified and five were included in this review. The findings reveal three main themes: perception, health seeking behavior and the social impact of infertility. In many Sub-Saharan Africa societies, there is negative perception of infertility problem as such those affected do not seek medical attention early. There is also a disproportionate social impact of infertility on women in the region. In Sub-Saharan Africa, high value is placed on children and those who are infertile are greatly stigmatized. In such a setting, the concept of reproductive health should include policies which could make it possible for couples and the whole society aware of the reality of infertility as a reproductive health problem and seek medical attention early.

Determinants of Infertility among Married Women Attending Dessie Referral Hospital and Dr. Misganaw Gynecology and Obstetrics Clinic, Dessie, Ethiopia

“…Failure of this often leads to unhappy married lives, divorces, and high levels of psychiatric morbidity [8]. Different studies have also shown that couples with infertility often face social stigmatization and are publically isolated [9]. Domestic violence and dissolution of marriage occur significantly more often among the infertile couples compared with couples in fecund relationships [8].…”

Use and pattern of previous care received by infertile Nigerian women

“…Another reason couples may opt for traditional assistance is to avoid detection of a male factor and accompanying social blame [2, 28]. The fact that health-seekers often seek health care (conventional and traditional) concurrently and sequentially was earlier confirmed by others [2, 29, 30]. This study however showed that success was higher with those that received conventional hospital treatment than those receiving traditional treatment.…”

“…High cost of conventional therapy, cultural and religious beliefs, and societal pressure to conceive may influence a woman’s decision to seek traditional treatment [8]. Another reason couples may opt for traditional assistance is to avoid detection of a male factor and accompanying social blame [2, 28]. The fact that health-seekers often seek health care (conventional and traditional) concurrently and sequentially was earlier confirmed by others [2, 29, 30].…”

“…Infertility is prevalent worldwide affecting about 5–8% of couples [1]. Prevalence of infertility in sub-Saharan Africa is higher, with 10–30% of couples affected in Nigeria [2]. It is one of the commonest reasons for women to seek gynaecologic consultation [3–5].…”

Torturing the helpless: A review of PCOS induced infertility from a gender perspective

“…Infertility is socially constructed in many SSA cultures, that is, men and women are viewed and perceived to become parents and women are specially socialized to become mothers in society (Chimbatata & Malimba, 2016). This is an unambiguous contrast to other societies in the west and the affluent world where individuals or couples could choose not to have a child or just to have them by adoption.…”